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Acute Psychiatric Wards (acute + psychiatric_ward)
Selected AbstractsPatients and nurses' perceptions of ward environmental factors and support systems in the care of suicidal patientsJOURNAL OF CLINICAL NURSING, Issue 1 2006Fan-Ko Sun PhD Aims., The aims of this paper are to present and discuss the findings that emerged from a qualitative study exploring nurses and patients' views of the acute psychiatric ward (the context) and the type of care received (the intervening conditions). Background., The phenomenon of suicide and the nursing care of people who are suicidal have previously been investigated. However, literature demonstrates that there is a dearth of information exploring the importance of the ward context in the care of suicidal patients and the intervening conditions that are used by professionals in the care of suicidal patients. Method., Qualitative research using the grounded theory approach. Data collection and analysis., Fifteen patients who had either suicidal ideas or had attempted suicide and 15 psychiatric nurses were interviewed and observed. Data were analysed using open, axial and selective coding. Findings., A substantive theory of suicide-nursing care was developed. For the purpose of this paper, the two categories that emerged in the ,context' element of the paradigm model are explored. They were: team working and the psychiatric ward environment. In addition, the four categories from the ,intervening conditions' are discussed. They were: nurses' attitudes and beliefs have an effect on caring, barriers to caring, patients' negative thoughts and feelings about the care provided and support systems. Conclusion., The findings indicated that the context of the ward environment and the intervening conditions used by nurses in the nursing care of suicidal patients helped to define some of the complex dynamics that impacted on the development of a therapeutic relationship within the practice of suicide-nursing care. Relevance to clinical practice., Environmental factors as well as the nurses' knowledge and skills and the type of support patients receive impact on the care of suicidal patients. These findings could help to enhance and advance suicide-nursing care. [source] Imperative ideals and the strenuous reality: focusing on acute psychiatryJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 1 2001J. K. Hummelvoll RPN RNT BA DrPH The aim of this study was to describe the complexity of the working situation on an acute psychiatric ward as well as how nurses balance tensions between ideals and the reality of daily work. By means of field research, the study aimed to arrive at a deeper understanding of the reality that nursing staff and patients experience. The analysis shows that the acute and unpredictable character of the working situation in combination with short hospital stays results in a tentative and summary nursing care characterized by ,therapeutic superficiality'. This constitutes a hindrance to encountering the patient as a person. The demand on ,treatment effectiveness' creates work-related stress. Hence, a partly articulated conflict develops between the professional and humanistic ideals of psychiatric nursing and the strenuous reality that the staff have to adjust to. This conflict is solved in various ways, depending on whether they belong to the pragmatic, idealist, traditionalist or enforcer attitude in relation to the ward's mandate. The demand on treatment effectiveness seems to promote a medical model in the daily work, even though a humanistic and existential approach can be traced in the nurses' caring philosophy. [source] The demography of nurses and patients on acute psychiatric wards in EnglandJOURNAL OF CLINICAL NURSING, Issue 6 2009Len Bowers Aims and objectives., To describe the ethnic and demographic composition of staff and patients on acute psychiatric wards in England. Background., A significant proportion of the UK population (7·6%) belong to an ethnic minority and there are concerns that ethnic minority patients are not well served by psychiatry, in particular that they are subject to excessive force and coercion. Design., Survey of a random sample of psychiatric wards in three regions. Methods., A survey was conducted of staff (n = 1536) and patients (n = 11 128) on 136 acute admission psychiatric wards. Results., Ethnic minority patients were more likely to be admitted with a diagnosis of schizophrenia, younger, more likely to be admitted for a risk of harm to others and more likely to be legally detained. The association between ethnic minority status and detention remains, even when risk, age, gender and diagnosis are taken into account. Ethnic minority patients come from areas of greater social deprivation and fragmentation. Ethnic concordance between staff and patients varies, but the greatest difference is found in London where the proportion of minority staff is greater than the proportion of minority patients. Conclusions., There continues to be evidence that ethnic minority patients are subject to an excessive amount of legal coercion in English mental health services. However, the proportion of staff belonging to an ethnic minority is greater than the proportion of patients. Relevance to clinical practice., Solutions to the problem of excessive use of legal coercion with ethnic minority patients need to be found. Changes of recruitment strategies are required if concordance is to be achieved. [source] Individual quality of life of people with severe mental disordersJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 1 2009A. PITKÄNEN mnsc People with mental disorders have been found to suffer from impaired quality of life (QoL). Therefore, the assessment of QoL has become important in psychiatric research. This explorative study was carried out in acute psychiatric wards. Thirty-five patients diagnosed with schizophrenia and related psychosis were interviewed. QoL was rated by the Schedule for Evaluation of Individual Quality of Life which is a respondent-generated QoL measure using semi-structured interview technique. Patients named five areas of life important to them and then rated their current status and placed relative weight on each QoL area. The data were analysed with qualitative content analysis and descriptive statistics. The most frequently named areas for QoL were health, family, leisure activities, work/study and social relationships, which represented 72% of all QoL areas named. Patients' average satisfaction with these QoL areas ranged 49.0,69.1 (scale 0,100). The mean global QoL score was 61.5 (standard deviation 17.4; range 24.6,89.6; scale 0,100). Awareness of patients' perceptions of their QoL areas can enhance our understanding of an individual patient's QoL and reveal unsatisfactory areas where QoL could be improved with individually tailored needs-based interventions. [source] Constraints and blocks to change and improvement on acute psychiatric wards , lessons from the City Nurses projectJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 5 2006G. BRENNAN rmn rnmh ba(hons) Recent years have seen sustained criticism and inspection of acute inpatient psychiatric wards, with the publication of reports and research leading to policy developments and a variety of efforts to improve perceived deficits. The City Nurses project seeks to reduce levels of conflict and containment on acute wards through the placement of expert nurses on wards to assist with the implementation of changes according to a working model of conflict and containment generation, based on previous research. Evaluation has shown significant decreases in aggression, absconding and self-harm by patients. However, in the course of working with the wards, various constraints and blocks to change have been identified and we describe these in detail in this paper. Analysis of the fieldwork diaries of the two City Nurses identified that change was hindered by limited staffing resources, problems with the physical environment and other resources, insufficient beds and the process of bed management, hierarchical ambiguity and multidisciplinary issues, the overdemanding role of the ward manager, and pervasive anxiety about the potential for serious untoward incidents and their implications for staff. We argue that sustained positive change in acute inpatient psychiatry requires these underlying structural issues to be both acknowledged and, if possible, resolved. [source] Reflections on the process of change on acute psychiatric wards during the City Nurse ProjectJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 3 2006C. FLOOD rn The intention of this paper is to discuss the process of therapeutic change on two acute psychiatric wards during a research project that aimed to reduce conflict and containment. Analysis of fieldwork notes, reflection, team discussion and supervision. The City Nurse Project successfully reduced patient aggression, self-harm and absconding. This paper reports on the reflections made over the course of the year as changes and developments to acute wards took place. Specifically discussed are the beneficial effects of an action research approach, the role of the City Nurse, support for ward managers, education and training, clinical supervision as well as difficulties and barriers to the overall process of change. At an interim stage of the project, the staff have shown a willingness to engage in efforts to change and improve two acute wards. This paper shows the potential to improve acute wards and produce positive outcomes using a working model. [source] Supplementary prescribing: potential ways to reform hospital psychiatric careJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 2 2006A. JONES phd rn The objective of this study was to explore perceptions held by nurses and psychiatrists towards the potential application of supplementary prescribing on acute psychiatric wards. Six focus groups were conducted with 19 nurses and seven psychiatrists who worked on three wards. Two major themes were identified: first, ways in which patients could receive care and treatment through supplementary prescribing and in new forms of partnership and second, ways by which nurses and psychiatrists could be organized to deliver their care through a supplementary prescribing framework. Nurses and psychiatrists were generally positive about the advent of prescribing and offered positive views as to how patient care could be improved and a general willingness for nurses to adapt and work differently. Findings from this exploratory study offer practical solutions to how supplementary prescribing could work on acute psychiatric wards. [source] Supplementary prescribing: relationships between nurses and psychiatrists on hospital psychiatric wardsJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 1 2006A. JONES phd bn (hons) rmn The purpose of this study was to explore some of the issues for the implementation of supplementary prescribing for acute hospital care. The study design was the use of focus group methodology. In total, 19 nurses and 7 psychiatrists joined 1 of 6 focus groups held on the psychiatric unit. The data were analyzed using a modified grounded theory technique. In the study to be reported here, nurses and psychiatrists described the potential for different ways of working to emerge on acute psychiatric wards. Two major themes were identified: supplementary prescribing bringing about different ways of influencing decisions and controlling professional work; nurses and psychiatrists developing different types of relationships. Findings suggest an overall positive acceptance for supplementary prescribing, but for greater attention to be placed on the nature of relationships between nurses and psychiatrists. Implications for practice include the impact on new roles for nurses and psychiatrists and how this new form of relationship can best serve patients. [source] Real world application of an intervention to reduce abscondingJOURNAL OF PSYCHIATRIC & MENTAL HEALTH NURSING, Issue 5 2005L. BOWERS rmn phd Absconding by acute psychiatric inpatients is associated with risk of harm to self and others, and creates considerable emotional as well as tangible burdens for staff. Previous research has led to the development of an effective nursing intervention to reduce absconding. In this project, that intervention was encapsulated in a self-training package, and offered freely to wards across the UK who agreed to implement it and audit the results. Fifteen wards completed this distributed audit, and achieved overall a 25.5% decrease in their absconding rates, as measured by official reports. The results support the efficacy of the intervention, and indicate that significant reductions can be made in absconding rates from unlocked or partially locked acute psychiatric wards. [source] Prescribing on psychiatric acute wards at four hospitalsPROGRESS IN NEUROLOGY AND PSYCHIATRY, Issue 3 2008MRCPsych, Richard Hodgson MSc Guidelines for prescribing psychotropic medication are available from a variety of sources; however, the case mix complexity on acute psychiatric wards might be expected to present challenges to adherence to these standards. Dr Hodgson and colleagues set out to audit prescribing on acute psychiatric wards at four hospitals covering similar catchment populations to ascertain practice. Copyright © 2008 Wiley Interface Ltd [source] | ||||||||||